Male and female patients of more than 20 years and above, representing all ethnic groups and areas of Pakistan presenting with bleeding per rectum with or without associated symptoms like mucosal prolapse, discharge, pruritis ani and pain as well having being diagnosed on history and proctoscopy findings like visible bleeding and engorged anal cushions were included in the study.

Our patients' symptoms were evaluated according to their anamnesis; this comprised pain, bleeding, mucosal prolapse, defecation problems such as constipation, and discomfort in daily life like pruritus and soiling.

These patients had severe mucosal prolapse and, as seen in pictures, ligation of all arteries accompanied by a continuous suture placed above the dentate line can effectively reduce and fix even prolapsed hemorrhoids.

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